EP1665997A2 - Verfahren zur durchführung einer opto-thermo-mechanischen aktion an einem biologischen gewebe und vorrichtung zur durchführung dieser aktion - Google Patents

Verfahren zur durchführung einer opto-thermo-mechanischen aktion an einem biologischen gewebe und vorrichtung zur durchführung dieser aktion Download PDF

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EP1665997A2
EP1665997A2 EP04816151A EP04816151A EP1665997A2 EP 1665997 A2 EP1665997 A2 EP 1665997A2 EP 04816151 A EP04816151 A EP 04816151A EP 04816151 A EP04816151 A EP 04816151A EP 1665997 A2 EP1665997 A2 EP 1665997A2
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biological tissue
optical
radiation
area
laser
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French (fr)
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EP1665997B1 (de
EP1665997A4 (de
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Emil Naumovich Sobol
Viktor Nikolaevich Bagratashvili
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ARCUO MEDICAL Inc
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Sobol Emil Naumovich
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00057—Light
    • A61B2017/00061—Light spectrum
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00115—Electrical control of surgical instruments with audible or visual output
    • A61B2017/00128—Electrical control of surgical instruments with audible or visual output related to intensity or progress of surgical action
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00642—Sensing and controlling the application of energy with feedback, i.e. closed loop control
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00666—Sensing and controlling the application of energy using a threshold value
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00904—Automatic detection of target tissue

Definitions

  • the invention relates to medicine, in particular to methods for medical treatment of biological tissues by locally modifying their structure and physical-chemical properties.
  • Patent RU No. 2114569, 07.09.93 a method for conducting a rhinological operation for modifying a human nasal septum cartilage shape.
  • the example described in this patent shows straightening of a curved human nasal septum using CO 2 -laser.
  • the cartilage plate in the curvature area of a nasal septum - the mucous tunic is separated, the cartilage plate is straightened and held in the straightened state using a known clamp.
  • This clamp usually comprises dual-branch, holding forceps having planar continuous branches, using which forceps the cartilage plate is captured, bent in the direction opposite to the pathological deformation, and is held during the entire time of irradiation. Then the cartilage is irradiated along the bending line by the scanning beam of CO 2 -laser, rate of scanning being 0.03 cm/s. After said irradiation the clamp is removed and the modified shape of the nasal septum is inspected visually.
  • This known method is used in cases of stenosis of larynx and trachea: to improve breathing, the contracted cartilage element of trachea is incised using an endoscope and CO 2 -laser, and then, using the same endoscope, the deformed cartilage tissues is irradiated by Nd:YAG-laser, having wavelength of 1.44 mc, through the mucous tunic, along the internal surface of the trachea's contracted cartilage element.
  • This method is advantageous in terms of delivery of radiation and of performing the visual inspection of the treated zone, particularly when modified is a shape of cartilages of a difficult-access localisation. But this method is complicated technically and requires two successive laser-aided actions. Furthermore, transfer of the pathologically deformed area of a cartilage tissue into its normal position requires a significant external mechanical action. Such action is performed using a flexible endoscope that serves as a mechanical bougie. Said endoscope has to have a sufficient mechanical strength and rigidity. But in view of a limited mechanical strength of the endoscope, this method can be applied only for dilating the cartilage element having a relatively small radial deformation, about 1-2 mm at most.
  • Said method is capable of irradiating a cartilage only across the internal surface of the annular element, while the external side remains inaccessible for irradiation.
  • the method is based on the laser-aided action, with simultaneous monitoring of the cartilage tissue parameters and varying of energy parameters of the laser-aided action.
  • Disadvantages of this method consist in that the positive outcome of change of a cartilaginous tissue shape is achieved in a narrow range of laser parameters, and a transgression beyond said range results in a damage to the tissue and recurrence of deformation; and the monitoring system employed in this method is based on measurement of the integral characteristic of a biological tissue, and dispenses with the spatial heterogeneity of said characteristics, which circumstance becomes the source of errors in selecting the moment when the laser-aided action should cease.
  • An essential drawback of this method is also lack of supervision over characteristics of the biological tissue in the area contiguous to the area of the direct laser-aided action, which circumstance brings about premises that the surrounding tissues would be affected, and augments the risk of side effects.
  • this method cannot be applied for treatment of damaged biological tissues, for example - articular cartilages and intervertebral disks.
  • Drawbacks of this approach consist of inevitable overheating of the tissues adjacent to the ablation zone, and of undesirable action affecting the surrounding tissues, which action manifests itself in formation of a rough scar tissue; also there is an high probability of recurrence of a disease, for this method - similarly to the conventional surgical removal of the diskal hernia - fails to eliminate the fibrous ring defect, which defect, in many cases, is the basic cause of a disease.
  • Said disadvantages and drawbacks are eliminated by the method according to this invention for effecting the optical-thermal-mechanical (OTM) action on a biological tissue, and using a device for carrying out the method.
  • Said method and device are adapted and devised to create the controlled spatial-temporal heterogeneities of temperature and heterogeneities of mechanical stresses in biological tissues by irradiating them by the optical irradiation, spatially and temporally modulated.
  • the spatial-temporal modulation (STM) of the optical radiation is a controlled, according to a predetermined rule, change in the spatial distribution of radiation power over time.
  • STM includes the pulse-periodic nature of the laser radiation and the known rules for laser beam scanning, but differs from them by an arbitrarily predetermined spatial-temporal distribution of the optical radiation, and, as a consequence thereof, by a possibility to modify, according to a predetermined rule, the spatial and temporal characteristics of the optical heating and of the thermal stresses' fields, i.e. STM owns broader capabilities to effect the OTM-action upon biological tissue, in particular - capabilities to control gradients of temperature and mechanical stresses.
  • chondrocytes, fibroblasts and some other cells of biological tissue are responsive to the external mechanical stresses' fields, and in particular the productive and regenerative capacity of cells can be enhanced or diminished - depending on parameters of an external mechanical action.
  • the controllability requirement is needed to ensure effectiveness and predictability of the action's effects and results.
  • the locality requirement is of importance due to the necessity to avoid an undesirable action on the surrounding tissues, to wit that the cells are to be safely acted upon.
  • the claimed method and device for carrying out the same provide formation of controllable and mutually matched spatial-temporal heterogeneities of temperature and thermo-mechanical stresses, as well as formation of acoustic waves in biological tissues.
  • a local thermal action to be effected on a biological tissue is required to perform a local irreversible change in micro-structure - "local melting of certain structural elements" of a biological tissue, which change leads to relaxation of mechanical stresses and creation of optimal heterogeneities of residual stresses in a tissue.
  • the mechanical action on the tissues is done according to the claimed method, and, in particular, on biological cells thereof, which cells participate in the tissue regeneration process; and apart from that - the controlled thermal action increases the rate of all physical-chemical processes underlying the medical treatment. But overheating of the tissue results in its denaturation and destruction in the direct action zone, and also leads to undesirable consequences outside the zone (contrary to the locality and safety principles).
  • a long-term result of the medical treatment action on a biological tissue depends both on kinetics, a degree of completion of irreversible process, and also on distribution of residual stresses after the laser-aided action has ceased.
  • the residual stresses' field influences operation of the cells for regeneration of tissue, then for attaining the positive effect and ensuring safety of the procedure, the thermal and mechanical actions effected on a biological tissue should be matched.
  • the invention is directed to provision of a method for effecting the optical-thermal-mechanical action on a biological tissue, and of a device therefor, which method and device provide an efficient and safe approach to trauma-free treatment of the diseases having causal nexus with deformation of, and damage to biological tissues, by way of creating the controlled residual stresses and the controlled spatial distribution of irreversible changes in the biological tissue structure.
  • radiation in the optical range of wavelengths is the laser radiation within the range of 0.1 to 11 ⁇ m.
  • the laser radiation can be of the pulsed or continuous nature.
  • Density of the laser radiation power is within the range of 1 to 1000 W/cm 2 .
  • Duration of exposure of a biological tissue area to irradiation is selected within the period of 0.1 s- 30 min.
  • the spatial formation of the optical radiation e.g: the laser radiation, is as follows:
  • the optical radiation parameters controlled in the course of the biological tissue area irradiation depending on the continuously measured characteristics of the spatial distribution of physical-chemical and geometric characteristics both of the area of the direct action effected on the biological tissue, and outside thereof are: a radiation wavelength, radiation power, power density and a spatial-temporal rule according to which said density varies, and also parameters of the modulation and spatial formation of laser radiation, for example - depth and frequency of modulation on the surface of, and in the bulk of the biological tissue, spatial distribution of radiation power.
  • a modulation depth according to the invention is 1-100%, a modulation frequency is within the bandwidth of 1-10 9 Hz.
  • Measurements of the spatial distribution of physical-chemical and geometric characteristics, both in the direct laser-aided action zone and outside thereof, are done taking into account the spectral composition of the signal representing the biological tissue area's response to the modulated laser irradiation of said area.
  • the inventive method further comprises the step of measurement of amplitude and phase of oscillations of the signal representing the biological tissue area's response to the modulated laser irradiation of said area.
  • a predetermined value of the laser radiation modulation frequency is selected such that it will match the resonance frequencies of mechanical vibrations in the area where the biological tissue is medically treated.
  • the biological tissue irradiation step is preceded by that of local application of brief pressures on biological tissue areas, for example on skin or mucous tunic that cover the medically treated tissue.
  • a device for effecting the medical treatment action on biological tissues comprising -
  • the optical radiation source comprises a laser radiation source.
  • the laser radiation source generates the laser radiation within the range of 0.1-11. ⁇ m.
  • the monitoring-diagnostic system includes at least one biological tissue condition sensor for measuring characteristics of the biological tissue area both in the medical treatment area and in immediate proximity thereto, which sensor is connected to a data processing unit that generates control signals for controlling the optical radiation parameters in the course of irradiation; and also a data visualisation and displaying device.
  • At least one biological tissue condition sensor in the monitoring-diagnostic system measures physical-chemical and geometric characteristics of the biological tissue area, such as temperature, water concentration in the biological tissue, mechanical stresses, light scattering characteristics, speed of sound, the optical-acoustic waves damping constant, geometric dimensions of biological tissue.
  • the unit for processing the signals supplied from the monitoring-diagnostic system basing on the signals, that arrive from at least one biological tissue condition sensor, delivers the control signals to the optical radiation source, to the unit for controlling the optical radiation power and temporal modulation, to the device for transferring the optical radiation and forming spatial distribution of the optical radiation power density on the surface of, and in the bulk of the biological tissue area, respectively.
  • the unit for controlling the optical radiation power and temporal modulation is implemented as an electro-optical modulator or acousto-optical modulator, or mechanical modulator.
  • modulation of optical radiation is performed by varying the pump power, e.g. that of the laser radiation source.
  • the device for transferring the optical radiation and forming the spatial distribution of optical radiation power density on the surface of, and in the bulk of the biological tissue area is implemented as a forming optical system and electro-optical scanner, both being mutually optically tied-in.
  • the device for transferring the optical radiation and forming the spatial distribution of the optical radiation power density on the surface of, and in the bulk of the biological tissue area is implemented as a forming optical system and a raster system, both being mutually optically tied-in.
  • Said forming optical system is implemented as a segment of an optical fibre or a system of lenses and mirrors that delivers the laser radiation from the optical radiation source to the biological tissue area.
  • the inventive data visualisation and displaying device is implemented, for example, as an endoscope or display for displaying the biological tissue area, or as an optical coherent tomograph.
  • the data visualisation and displaying device performs measurement of geometric characteristics of the biological tissue area.
  • the feedback is executed by the monitoring-diagnostic system basing on the optical-thermal response of the biological tissue to the temporally-modulated laser radiation.
  • the feedback is also executed by the monitoring-diagnostic system basing on analysis of spectral composition of the biological tissue's signal responding to the laser's modulated action.
  • the feedback is executed by the monitoring-diagnostic system basing on analysis of amplitude and phase of the biological tissue's signal responding to the laser's modulated action.
  • the temporal rule of the laser radiation modulation - in particular: amplitude, depth, frequency and modulation mode - are determined by the monitoring-diagnostic system according to the pre-operative diagnostics data and updated in the course of the laser-aided action basing on a control signal from said monitoring-diagnostic system.
  • the rule for formation of the laser radiation spatial distribution is determined according to the pre-operative diagnostics data and updated in the course of the laser-aided action on the basis of a control signal from the monitoring-diagnostic system.
  • Parameters of the scanning process or of the laser radiation spatial distribution are determined according to the pre-operative diagnostics data and updated in the course of the laser-aided action on the basis of a control signal from the monitoring-diagnostic system.
  • matching of the rules for modulation and spatial formation of the laser radiation is done basing on the pre-operative diagnostics data, and said rules are updated in the course of the laser-aided action on the basis of the monitoring-diagnostic system's signal.
  • the feedback is executed on the basis of the biological tissue's optical-acoustic response to the modulated laser radiation generated in conformity with a predetermined spatial distribution on the surface of, and in the bulk of the biological tissue.
  • the feedback is also executed on the basis of the optical-electrical response of the biological tissue to the modulated laser radiation generated according to a predetermined spatial distribution on the surface of, and in the bulk of the biological tissue.
  • the feedback is also executed on the basis of monitoring of changes of biological tissue's optical properties that take place when the tissue is exposed to the action effected by the laser radiation modulated and generated according to a pre-determined spatial distribution on the surface of, and in the bulk of biological tissue.
  • At least one biological tissue condition sensor in the monitoring-diagnostic system can be positioned directly in the biological tissue area using a surgical instrument.
  • the claimed method and a device therefor allow to:
  • the important peculiarity of the invention consists in that the use of the laser radiation modulation allows modify basically the operation of monitoring-diagnostic systems that will register the biological tissue's response exactly to the modulated action.
  • Fig. 1 shows a schematic diagram of a device for effecting the medical action on a biological tissue to exemplify the claimed method for effecting the optical-thermal-mechanical action effected on said biological tissue.
  • the device for effecting a medical action on a biological tissue consists: of a source 1 of optical radiation; a unit 2 for controlling the optical radiation power and temporal modulation; a device 3 for transferring optical radiation and forming the spatial distribution of a optical radiation power density on the surface of, and in the bulk of the biological tissue; a monitoring-diagnostic system 4; said system including: a data visualisation and displaying device 5, at least one biological tissue condition sensor 6, a data processing unit 7; the biological tissue area to be medically treated has reference numeral 8.
  • the optical radiation source 1 is a laser radiation source and can be implemented both as a pulse-periodic source and a continuous radiation source having the temporally-modulated output power.
  • This can be, for example a pulse-periodic Nd:YAG laser having wavelength of 1.32 ⁇ m, or a continuous fibre laser emitting the periodically-modulated radiation on wavelength 1.56 ⁇ m.
  • the unit 2 for controlling the optical radiation power and temporal modulation can be both an internal component of a laser excitation system, and an external unit not directly coupled to the laser.
  • the radiation is modulated by modulating a laser pump power, for example - by modulation of the power supply voltage.
  • the radiation can be modulated, for example, using an electro-optical modulator, acousto-optical modulator (interrupter).
  • the device 3 for transferring the optical radiation and forming the spatial distribution of an optical radiation power density on the surface of, and in the bulk of the biological tissue can be implemented in two types.
  • the first type uses periodic or aperiodic scanning of laser beam across a biological tissue along three axes. In this type, frequency and amplitude of scanning may vary so that to provide optimal conditions for the action to be effected on a tissue.
  • an electro-optical scanner for example, can be used as the scanner.
  • an optical system for example, a raster system
  • formed is a laser spot on the biological tissue surface having a pre-determined, in particular by the spatially-modulated radiation (e.g. periodically varying over space), distribution of the power density across the spot.
  • the laser radiation is transferred from the radiation source (1) to the biological tissue using a forming optical system implemented as a system of lenses and mirrors, or as an optical fibre segment.
  • the monitoring-diagnostic system 4 consists of the data visualisation and displaying device 5, which device is implemented, for example, as an endoscope provided with a display or an optical coherent tomograph, at least one biological tissue condition sensor 6 and the data processing unit 7 that generates, basing on the signals from at least one biological tissue condition sensor, the controlling instructions for the optical radiation source 1, the unit 2 for controlling the optical radiation power and temporal modulation, and the device 3 for delivery of the optical radiation and forming the spatial distribution of the optical radiation power density.
  • the controlling instructions for the optical radiation source 1 the unit 2 for controlling the optical radiation power and temporal modulation
  • the device 3 for delivery of the optical radiation and forming the spatial distribution of the optical radiation power density.
  • the biological tissue condition sensor(s) 6 are the devices that register changes of physical-chemical properties of the biological tissue subjected to the OTM-action and, depending on a type of the medical action applied, type, localisation and dimensions of a medically treated biological tissue, they can be the customised sensors of temperature, amplitude, phase and frequency of acoustic signals, the mechanical stress sensors, the amplitude, phase and frequency sensors, as well as those of spatial distribution of scattered light, sensors of water concentration in the irradiated biological tissue.
  • the data processing unit (7) can be implemented as at least one computer circuit board, e.g. Intel Pentium-2 processor, audio card DC-XG Legacy Sound System, or a virtual multi-channel oscillograph, integrated with a computer and intended for processing the signals from the monitoring-diagnostic system's sensors (6) and for forming, in conformity with a specified algorithm, the control signals for the optical radiation source (1), for the unit (2) for controlling the optical radiation and power temporal modulation, and for the device (3) for transferring optical radiation and forming the power density spatial distribution - so that said units and devices will modify power of radiation, parameters of modulation and the spatial distribution of the optical radiation power density on the surface of, and in the bulk of the biological tissue, or will turn the laser off.
  • Intel Pentium-2 processor e.g. Intel Pentium-2 processor, audio card DC-XG Legacy Sound System, or a virtual multi-channel oscillograph
  • At least one biological tissue condition sensor 6 is secured adjacently to, or in the direct contact with the irradiated tissue so that to ensure optimal obtainment of information of a biological tissue condition.
  • the method for effecting the OTM-action on a biological tissue is carried out as follows.
  • An area of a given biological tissue to be medically treated is defined beforehand using, for example, the data visualisation and displaying device 5, or basing on data of the pre-operative tomography examination of a patient.
  • the biological tissue condition sensor(s) 6 of the monitoring-diagnostic system 4 are disposed, and said monitoring-diagnostic system is turned on to determine the spatial distribution of physical-chemical and geometric properties of the biological tissue in the medical treatment area; for example the spatial distribution of mechanical stresses is measured by a stress-measuring micro-device, acoustic vibrations damping constant is measured during excitation of optical-acoustic waves by way of effecting a low-intensity modulated laser-aided action (power density being 0.01 - 0.5 W/cm 2 ), at which intensity temperature changes in the laser-aided action zone would not exceed 1 K.
  • power density being 0.01 - 0.5 W/cm 2
  • Spatial distribution of temperature in the biological tissue is measured, for example, using a micro-thermocouple and a scanning infra-red imager. Geometric properties (shape and sizes) of the medically treated biological tissue area are determined using the data visualisation and displaying device 5, e.g. using an optical coherent tomograph. Spatial distribution of heterogeneity of the biological tissue structure is determined, for example, using an optical coherent tomograph.
  • the patient's pre-operative examination data are processed using the data processing device 7, which device, on the basis of a pre-determined algorithm, issues recommendations as to selection of initial parameters of irradiation by laser.
  • a shape and sizes of the laser spot and a scanning rule are selected according to the geometric properties and spatial distribution of stresses in the medically treated biological tissue area.
  • a pre-determined value of the optical radiation modulation frequency is selected, for example, such that it will match the resonance frequencies of mechanical vibrations in the medically treated biological tissue area.
  • the laser radiation parameters are determined, for example: wavelength - 1.5 ⁇ m; laser source power - 2 W, laser radiation spot shape - circle of 1 mm in diameter, for example; modulation frequency - 26 Hz, modulation depth - 80%, a rule for radiation scanning over space (along three axes) and over time.
  • treated is a deformed cartilaginous tissue
  • medically treated tissue is imparted, if necessary, a predefined shape by the mechanical action using a surgical instrument.
  • a mechanical tool is also used for applying a local pressure onto areas of the biological tissue, for example - skin or mucous tunic that cover the medically treated biological tissue area.
  • a local pressure improves safety of the OTM-action.
  • water concentration decreases locally and, accordingly, radiation absorption coefficient locally diminishes in the near-surface layers of said biological tissue, which provides a shift of the temperature maximum into bulk of the medically treated biological tissue, and prevents overheating of, and damage to the surface layers of skin, mucous tunic and perichondrium.
  • the device for effecting the OTM-action on a biological tissue according to the invention is operated as follows.
  • Optical radiation e.g. the laser radiation
  • the unit 2 for controlling the optical radiation power and temporal modulation (for example, using an acousto-optical modulator), and using an optical forming system, for example, using an optical fibre
  • said radiation is supplied to the device 3 for formation of the spatial distribution of the optical radiation power density, being, for example, a micro-lens optical raster, disposed in vicinity of the surface (at distance of 5-10 mm) of the biological tissue irradiated area.
  • Heating of the biological tissue by the laser radiation results in a change in the spatial distribution of its geometric and physical-chemical characteristics, such as field of temperatures, field of stresses and the laser radiation scattering diagram, which properties being continuously monitored by the data visualisation and displaying device 5, for example an optical coherent tomograph of IMALUX type; by the sensors 6, for example a scanning IR-radiometer or a stress-measuring micro-device based on a resistance stress gauge, or by an optical multi-channel analyser, for example - MORS-11.
  • Signals from the sensors 6 and the data visualisation and displaying device 5 are continuously output to the data processing unit 7, where the signals are processed and supplied to a video display for continuous visual monitoring to enable the visual supervision over characteristics of the irradiated tissue and to allow the manual control of the irradiation parameters.
  • the data processing unit 7, basing on signals from the sensors 6 and data the visualisation and displaying device 5, generates, according to a specific algorithm, instructions for the optical radiation power and temporal modulation control device 2 and the device 3 for delivering the optical radiation and forming the spatial distribution so that to modify power, temporal modulation parameters and parameters of the spatial distribution of the optical radiation power density; and also generates the instruction to the optical source radiation 1 to turn off when the required characteristics of the irradiated biological tissue are attained, for example when temperature of nasal septum cartilage reaches 70°C.
  • the pre-operative examination including computerised tomography and discography; ascertained the presence of instability of spinal column and the presence of a defect in fibrous ring of the operated interverterbral disk.
  • first topology and dimensions of the defect were determined, and distribution of mechanical stresses in the fibrous ring area was determined using a strain-measuring micro-device inserted into the interverterbral disk through the needle 1.6 mm in diameter.
  • the laser radiation source Er-glass fibre laser was selected and had wavelength of 1.56 ⁇ m, radiation power of 0.2-5 W, in said laser the radiation was modulated at frequencies within the bandwidth of 1-80 Hz and in depth of 50-100%.
  • the following initial parameters of the laser radiation were selected: laser source power - 0.9 W, modulation frequency - 5 Hz, modulation depth - 80%.
  • Local anesthesia (novocaine injection) was used.
  • the radiation was delivered to the defect zone through a fibre-optic waveguide 600 ⁇ m in diameter, inserted into a metal needle 25 cm long and having outer diameter of 1.2 mm.
  • Female patient, 55 referred to the clinic with the request to eliminate some aesthetical disadvantages of her nose shape.
  • Nd:YAG solid-state pulsed-periodic laser was selected and had the following characteristics: wavelength - 1.32 ⁇ m, average radiation power - 0.3-5 W, pulse duration - 1 ms, pulse succession frequency: 10-700 Hz.
  • the radiation spatial distribution unit was adapted to focus the radiation in the form of four circular spots having diameter of 0.4 - 3 mm, spaced at a distance 0.5 to 10 mm; the radiation was scanned along three axes at rate of 0.1-20 cm/s.
  • the scattered radiation phase and the micro-thermocouple signal were used; the nose wings were additionally irradiated by a low-intensity light source provided by a diode laser having wavelength of 0.68 ⁇ m.
  • a diode laser having wavelength of 0.68 ⁇ m.
  • Two symmetrically disposed nose wings' cartilages were given a new predetermined shape using a surgical instrument that provided a smooth curvature of the cartilages within the nose wings, without their surgical exposure.
  • Two cartilage plates were irradiated alternately by the laser radiation pulses at frequency of 20 Hz through an optical fibre and optical raster system.
  • Power of the laser radiation during first 12s of irradiation was 2.5 W, then, after the micro-thermocouple's signal was received to indicate that temperature of the heated cartilage became steady at 52°C, the power was raised to 4.4 W.
  • the laser was turned off after the monitoring-diagnostic system had outputted the signal as to the change of the light scattering signal phase by 180°C evidencing completion of the process of stress relaxation in the heated cartilage.
  • the heating time by laser power of 4.4 W was 4.2 and 5.1 s, respectively, the same temperature of 68°C having been reached.
  • the post-operative diagnostics using an optical coherent tomography and carried out immediately after the operation and 6 after months showed stability of the newly-imparted configuration of both nose wings, without visible damages to the mucous tunic and other adjacent tissues.
  • selected modes of the OTM-action by the temporally modulated and spatially formed laser-aided action on the deformed nose wings' cartilage plates provided the process of the controlled irreversible modification and resulted in the desirable cosmetic effect - the deformed nose wings acquired the predetermined shape.
  • Er-glass fibre laser having wavelength of 1.56 ⁇ m, radiation power of 0.2-5 W, initial modulation of radiation of 365 Hz and depth of 30%.
  • a monitoring-diagnostic system based on an optical-acoustic sensor and strain-measuring micro-device was used.
  • a laser source having a lowered power level of 0.1 W and spot 1 mm in diameter was employed and scanned linearly in the medically treated cartilaginous tissue area at frequency of 0.1 Hz and amplitude of 5 cm; in so doing, the spatial distribution of amplitude of the optical-acoustic signal was being measured, and basing on said distribution a data processing device (7 in Fig. 1) selected the initial laser power spatial distribution.
  • the laser spot on the mucous tunic surface, through which the cartilages were irradiated, was selected in the form of the strip 28 mm long and 0.3 mm wide and extending along the cartilage plate curvature line at distance of 5 mm from the cartilage growth zone; which strip ensured avoidance of overheating of the plate.
  • the steps of straightening and fixation of a predetermined nasal septum shape, as well as the step of application of the mechanical pressure on the mucous tunic that covered the cartilaginous tissue in the medical treatment area, were carried out using a surgical instrument.
  • the laser-aided heating was performed for 6 s, with the laser radiation power of 4.5 W.
  • the laser was turned off after receipt of the stress-measuring micro-device signal indicating that the spatial heterogeneity of residual stresses in the nasal septum had been reached at level of 10%.
  • Characteristic pitch of said heterogeneities was 300 ⁇ m, which value correlates with the characteristic distance between the active cells of the cartilaginous tissue - chondrocytes.
  • the tomographical and rhinoscopic examinations carried out immediately after the irradiation and also after 3 and 9 months, showed stability of the newly-imparted shape of the nasal septum cartilage and equality of gas flows via both nose airways.
  • Optical coherent tomography did not find any damages in the mucous tunic adjacent to the nasal septum and in perichondrium.
  • the selected modes of the OTM-action effected on the nasal septum deformed cartilage by the temporally-modulated and spatially-formed laser-aided action provided the controlled heterogeneity of residual mechanical stresses in the cartilaginous tissue, which resulted in the desired medical effect - straightening of the nasal septum and restoration of normal breathing.
  • safety of restoration of the cartilage shape was ensured, because during the laser-aided OTM-action, the cartilage growth zone was not affected, which circumstance avoids any abnormalities of development and disproportions that may emerge as aftermath of the conventional, accompanied with traumas surgery.
  • the invention provides a novel method for effecting the controlled optical-thermal-mechanical action on the spatial heterogeneity of temperature of stresses and of structure of biological tissues.
  • the claimed method for effecting the optical-thermal-mechanical action on a biological tissue, and device therefor can be suitably used in various fields of medicine, in particular in otolaryngology and cosmetology for correcting shapes of cartilaginous tissues, in ophthalmology for correcting cornea, in orthopedics and spinal surgery for treatment of diseases of joints and interverterbral disks.
EP04816151A 2003-09-18 2004-09-17 Vorrichtung zur durchführung einer opto-thermo-mechanischen aktion an einem biologischen gewebe Not-in-force EP1665997B1 (de)

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RU2003128064/14A RU2372117C2 (ru) 2003-09-18 2003-09-18 Способ опто-термо-механического воздействия на биологическую ткань и устройство для его осуществления
PCT/RU2004/000454 WO2005025400A2 (fr) 2003-09-18 2004-09-17 Procede de traitement optique, mecanique et thermique d'un tissu biologique et dispositif prevu a cet effet

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN111141941A (zh) * 2020-01-16 2020-05-12 广州思林杰网络科技有限公司 一种双通道示波器及其控制方法和存储介质

Families Citing this family (47)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20080154257A1 (en) * 2006-12-22 2008-06-26 Shiva Sharareh Real-time optoacoustic monitoring with electophysiologic catheters
US20060254358A1 (en) * 2004-11-12 2006-11-16 Harald Merkel Apparatus and a method for determining the spatial distribution of physical parameters in an object
CN101083936B (zh) * 2004-12-20 2010-06-23 皇家飞利浦电子股份有限公司 身体结构研究
US8109981B2 (en) 2005-01-25 2012-02-07 Valam Corporation Optical therapies and devices
US10426548B2 (en) * 2006-02-01 2019-10-01 The General Hosppital Corporation Methods and systems for providing electromagnetic radiation to at least one portion of a sample using conformal laser therapy procedures
US20070219600A1 (en) * 2006-03-17 2007-09-20 Michael Gertner Devices and methods for targeted nasal phototherapy
US20070287991A1 (en) * 2006-06-08 2007-12-13 Mckay William F Devices and methods for detection of markers of axial pain with or without radiculopathy
EA200700529A1 (ru) * 2007-01-17 2008-08-29 Эмиль Наумович Соболь Способ лечения сколиоза и система для его осуществления
WO2008143955A2 (en) 2007-05-14 2008-11-27 The Regents Of The University Of Colorado Laser fusion of tissue layers
ATE511787T1 (de) * 2007-12-28 2011-06-15 Koninkl Philips Electronics Nv Gewebeablationsvorrichtung mit photoakustischer läsionsbildungsrückmeldung
DE102008005053A1 (de) * 2008-01-18 2009-07-30 Rowiak Gmbh Laserkorrektur von Sehfehlern an der natürlichen Augenlinse
EA011465B1 (ru) * 2008-05-26 2009-04-28 Эмиль Наумович Соболь Способ коррекции зрения и устройство для его осуществления
EP2348978B1 (de) 2008-10-03 2017-12-06 HLZ Innovation, Llc Anpassbare pneumatische stützfläche
US8715347B2 (en) 2010-04-17 2014-05-06 Chondrocyte, LLC Devices and methods for reshaping cartilage structures
US9125677B2 (en) * 2011-01-22 2015-09-08 Arcuo Medical, Inc. Diagnostic and feedback control system for efficacy and safety of laser application for tissue reshaping and regeneration
US20120191005A1 (en) * 2011-01-22 2012-07-26 Emil Naumovich Sobol Diagnostic and Feedback Control for Efficacy and Safety of Laser Application for Tissue Reshaping and Regeneration
US10456185B2 (en) 2011-06-14 2019-10-29 Aerin Medical, Inc. Methods and devices to treat nasal airways
US9415194B2 (en) 2011-06-14 2016-08-16 Aerin Medical Inc. Post nasal drip treatment
US10722282B2 (en) 2011-06-14 2020-07-28 Aerin Medical, Inc. Methods and devices to treat nasal airways
US11304746B2 (en) 2011-06-14 2022-04-19 Aerin Medical Inc. Method of treating airway tissue to reduce mucus secretion
US11241271B2 (en) 2011-06-14 2022-02-08 Aerin Medical Inc. Methods of treating nasal airways
US9237924B2 (en) 2011-06-14 2016-01-19 Aerin Medical, Inc. Methods and devices to treat nasal airways
US8986301B2 (en) 2012-06-13 2015-03-24 Aerin Medical Inc. Methods and devices to treat nasal airways
US11033318B2 (en) 2011-06-14 2021-06-15 Aerin Medical, Inc. Methods and devices to treat nasal airways
TWI484154B (zh) * 2012-02-24 2015-05-11 光學檢測裝置及其運作方法
ES2440368B1 (es) * 2012-07-26 2015-03-06 Univ Zaragoza Biosensor con nanoparticulas metálicas
US9439731B2 (en) * 2013-05-28 2016-09-13 Chondrocyte, LLC Methods for reshaping cartilage structures
US10603059B2 (en) 2013-09-13 2020-03-31 Aerin Medical Inc. Hyaline cartilage shaping
WO2015048806A2 (en) 2013-09-30 2015-04-02 Nidus Medical, Llc Apparatus and methods for treating rhinitis
US9763743B2 (en) 2014-07-25 2017-09-19 Arrinex, Inc. Apparatus and method for treating rhinitis
CN104147705A (zh) * 2014-08-27 2014-11-19 重庆大学 一种可产生时变光强输出的光子治疗装置
WO2016069788A1 (en) 2014-10-29 2016-05-06 Spectral Md, Inc. Reflective mode multi-spectral time-resolved optical imaging methods and apparatuses for tissue classification
WO2017074505A1 (en) * 2015-10-28 2017-05-04 Spectral Md, Inc. Reflective mode multi-spectral time-resolved optical imaging methods and apparatuses for tissue classification
US9872621B2 (en) * 2014-12-17 2018-01-23 Intel Corporation Multispectral measurement for improved biological signal acquisition
WO2017152061A1 (en) 2016-03-04 2017-09-08 Aerin Medical, Inc. Eustachian tube modification
US11806071B2 (en) 2016-12-22 2023-11-07 Aerin Medical Inc. Soft palate treatment
WO2018119071A1 (en) 2016-12-22 2018-06-28 Aerin Medical, Inc. Soft palate treatment
US20220240783A1 (en) 2017-03-02 2022-08-04 Spectral Md, Inc. Machine learning systems and techniques for multispectral amputation site analysis
CA3061352A1 (en) 2017-04-28 2018-11-01 Arrinex, Inc. Systems and methods for locating blood vessels in the treatment of rhinitis
USD880694S1 (en) 2017-05-01 2020-04-07 Aerin Medical, Inc. Nasal airway medical instrument
US11096738B2 (en) 2017-05-05 2021-08-24 Aerin Medical, Inc. Treatment of spinal tissue
CA3004065C (en) * 2017-05-05 2023-02-14 Institut National D'optique Light modulation for improved photoacoustic feedback on light-induced treatments and procedures
USD902412S1 (en) 2018-10-31 2020-11-17 Aerin Medical, Inc. Electrosurgery console
USD881904S1 (en) 2018-10-31 2020-04-21 Aerin Medical Inc. Display screen with animated graphical user interface
EP3893733A4 (de) 2018-12-14 2022-10-12 Spectral MD, Inc. Maschinenlernsysteme und verfahren zur beurteilung, heilungsprognose und behandlung von wunden
KR20210099126A (ko) 2018-12-14 2021-08-11 스펙트랄 엠디, 인크. 고정밀도 다중-애퍼쳐 스펙트럼 이미징을 위한 시스템 및 방법
EP4342407A1 (de) 2022-09-23 2024-03-27 Terra Quantum AG Lasersystem und verfahren zur erfassung und verarbeitung von informationen

Citations (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4718417A (en) * 1985-03-22 1988-01-12 Massachusetts Institute Of Technology Visible fluorescence spectral diagnostic for laser angiosurgery
US4973848A (en) * 1989-07-28 1990-11-27 J. Mccaughan Laser apparatus for concurrent analysis and treatment
US5269778A (en) * 1988-11-01 1993-12-14 Rink John L Variable pulse width laser and method of use
WO1997039690A1 (en) * 1996-04-24 1997-10-30 The Regents Of The University Of California Opto-acoustic thrombolysis
WO1998055035A1 (en) * 1997-06-04 1998-12-10 Joseph Neev Method and apparatus for high precision variable rate material removal and modification
DE19916653A1 (de) * 1999-04-14 2000-10-19 Holger Lubatschowski Optoakustische Gewebsdifferentierung zur patientenspezifischen Dosierung der Laserstrahlung bei der Zyklophotokoagulation des Auges
WO2002032335A1 (en) * 2000-07-25 2002-04-25 Rita Medical Systems Inc. Apparatus for detecting and treating tumors using localized impedance measurement
EP1279374A1 (de) * 1999-02-26 2003-01-29 Nidek Co., Ltd Laserdepiliergerät
US20030036751A1 (en) * 2001-05-30 2003-02-20 Anderson R. Rox Apparatus and method for laser treatment with spectroscopic feedback
US6542767B1 (en) * 1999-11-09 2003-04-01 Biotex, Inc. Method and system for controlling heat delivery to a target

Family Cites Families (14)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
SU525042A1 (ru) * 1975-06-02 1976-08-15 Предприятие П/Я Р-6681 Электрооптический модул тор света
US4316467A (en) * 1980-06-23 1982-02-23 Lorenzo P. Maun Control for laser hemangioma treatment system
IL75998A0 (en) * 1984-08-07 1985-12-31 Medical Laser Research & Dev C Laser system for providing target tissue specific energy deposition
US5318024A (en) * 1985-03-22 1994-06-07 Massachusetts Institute Of Technology Laser endoscope for spectroscopic imaging
DK130586A (da) * 1985-03-22 1986-09-23 Massachusetts Inst Technology Laser-kateter til indfoering i arterier
JPH01135371A (ja) * 1987-11-20 1989-05-29 Olympus Optical Co Ltd レーザ光照射装置
JPH01250271A (ja) * 1987-12-04 1989-10-05 Olympus Optical Co Ltd 医用レーザ照射装置
ZA948393B (en) * 1993-11-01 1995-06-26 Polartechnics Ltd Method and apparatus for tissue type recognition
RU2113820C1 (ru) * 1994-03-02 1998-06-27 Калюжный Владимир Викторович Способ компьютерной медицинской интроскопии и компьютерный томограф для его осуществления
US5591157A (en) * 1994-09-07 1997-01-07 Hennings; David R. Method and apparatus for tympanic membrane shrinkage
RU2138192C1 (ru) * 1995-03-06 1999-09-27 Полартекникс, Лтд. Способ распознавания типа ткани и аппарат для осуществления способа
RU2224474C2 (ru) * 1999-09-30 2004-02-27 Соболь Эмиль Наумович Способ лечения деформированной хрящевой ткани и инструмент для его осуществления
US6589235B2 (en) * 2000-01-21 2003-07-08 The Regents Of The University Of California Method and apparatus for cartilage reshaping by radiofrequency heating
RU2196623C2 (ru) * 2000-07-21 2003-01-20 Соколов Виктор Викторович Способ лечения злокачественных опухолей

Patent Citations (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4718417A (en) * 1985-03-22 1988-01-12 Massachusetts Institute Of Technology Visible fluorescence spectral diagnostic for laser angiosurgery
US5269778A (en) * 1988-11-01 1993-12-14 Rink John L Variable pulse width laser and method of use
US4973848A (en) * 1989-07-28 1990-11-27 J. Mccaughan Laser apparatus for concurrent analysis and treatment
WO1997039690A1 (en) * 1996-04-24 1997-10-30 The Regents Of The University Of California Opto-acoustic thrombolysis
WO1998055035A1 (en) * 1997-06-04 1998-12-10 Joseph Neev Method and apparatus for high precision variable rate material removal and modification
EP1279374A1 (de) * 1999-02-26 2003-01-29 Nidek Co., Ltd Laserdepiliergerät
DE19916653A1 (de) * 1999-04-14 2000-10-19 Holger Lubatschowski Optoakustische Gewebsdifferentierung zur patientenspezifischen Dosierung der Laserstrahlung bei der Zyklophotokoagulation des Auges
US6542767B1 (en) * 1999-11-09 2003-04-01 Biotex, Inc. Method and system for controlling heat delivery to a target
WO2002032335A1 (en) * 2000-07-25 2002-04-25 Rita Medical Systems Inc. Apparatus for detecting and treating tumors using localized impedance measurement
US20030036751A1 (en) * 2001-05-30 2003-02-20 Anderson R. Rox Apparatus and method for laser treatment with spectroscopic feedback

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See also references of WO2005025400A2 *

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN111141941A (zh) * 2020-01-16 2020-05-12 广州思林杰网络科技有限公司 一种双通道示波器及其控制方法和存储介质
CN111141941B (zh) * 2020-01-16 2022-05-03 广州思林杰科技股份有限公司 一种双通道示波器及其控制方法和存储介质

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US20050119643A1 (en) 2005-06-02
CN1784185B (zh) 2010-12-08
EP1665997B1 (de) 2011-12-28
CN1784185A (zh) 2006-06-07
UA85673C2 (uk) 2009-02-25
RU2372117C2 (ru) 2009-11-10
AU2004271876A1 (en) 2005-03-24
JP2007505679A (ja) 2007-03-15
MXPA05009981A (es) 2006-03-30
ATE538745T1 (de) 2012-01-15
EP1665997A4 (de) 2009-10-21
WO2005025400A2 (fr) 2005-03-24
RU2003128064A (ru) 2005-03-27
WO2005025400A3 (fr) 2005-06-09

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